Make Medicare Simple, Clear, and Approachable Transcript

Announcer  00:00

No need to lose sleep over planning your Medicare coverage. Lisa, Laura and the team at Secure Money Health want you to get the best, most customized service when planning your Medicare coverage. In fact, Lisa wants to share her new book with you, the Ultimate Medicare Book. It’ll help you choose the right plan, understand your benefits and avoid common pitfalls. Go to mymedicarebook.com. That’s mymedicarebook.com. It’s time to secure all your healthcare needs.

 

Lisa Lauro  00:34

And we will really simplify the process.

 

Speaker 2  00:37

Welcome to Secure Health with Lisa Lauro

 

Steve Sedahl  00:46

Hey, we’re back on the Secure Money Health radio. I don’t know why I have trouble with that, Lisa, but I do. How are you?

 

Lisa Lauro  00:54

I’m good. How are you today?

 

Steve Sedahl  00:56

Good, good, good. Secure Money Health radio, and again, right alongside secure money advisors, where we do the show On the Money with Secure Money and Brian Quaranta, and this is really the counterpart to that, talking about Medicare. And before we jump in, I want to mention your book, Lisa. She wrote a book called The Ultimate Medicare Book, simplifying Medicare so you can make confident and informed decisions. It’s a quick read. Lisa, describe me for me the book, and what motivated you to write it?

 

Lisa Lauro  01:27

Oh, yes, you know the book is, is such a great resource, and it’s not just for people turning 65 so that’s what I like about it, is anybody at any age, you know, if you’re getting ready turn 65 and beyond, this book is for you, and the reason I say that is because it has so many great nuggets of information for all different topics, about using, understanding Medicare, the different types of plans available. What’s good about them? What are the pros? What are the cons? What are some things to look out for? So, it’s and it’s such a quick read, it’s an easy guide for you with a wealth of information. So, I love my book. I what inspired me to write it was I felt like there really was a need for this book, I wanted something that I could offer my clients and prospects, people coming in. We don’t charge for the book. It’s complimentary, so I’m happy to just give it to you and I just think it’s a great resource. I felt like there was a need for it as part of my practice.

 

Steve Sedahl  02:39

Well, again, I think it’s important to you. Pointed out at the beginning, it’s not just because, if you’re not 65 this is if you’re helping somebody who’s getting close to 65 if you’re turning 65 in a few years, read the book. It gives you information. And that’s right. Knowledge is power

 

Lisa Lauro  02:54

You are absolutely right. And it’s, it’s for the caregivers, right, right? I mean, as you’re getting ready, I off. This is If I hear one thing, if I had to pick one thing to talk about that I hear all the time. Okay, you want to know what it is? Steve, yes, it’s, I don’t know how my parents did this. That’s what people tell me. This is so confusing. I don’t know how my parents did this. And so Medicare, navigating Medicare, okay, right back in the day, they didn’t have the resources we had, they didn’t have the internet, they didn’t and it’s confusing, right? And so that’s what people tell me, and so I That’s why I felt like there was a need for it. But this is for the caregivers. This is for the sons and daughters helping their parents make a decision. So, tell me how I can get my hands on one. You can go to medicaresimpleguide.com. That’s medicaresimpleguide.com. Get yourself a complimentary copy of the Ultimate Medicare Book. I promise you will not be sorry. I’m going to mail it right to your house in a pretty envelope. It’ll stand right out in your mail and you will love it. You will find it as a good resource.

 

Steve Sedahl  04:13

All right, very good Lisa. Very good folks. 724-242-6828, is a phone number you can call right now and set up a time to sit down with Lisa and talk about Medicare. So, we’re talking about insulin. That’s got to be another hot topic, or certainly a continuing topic. So, is insulin covered by Medicare Part B? I think I know the answer

 

Lisa Lauro  04:32

yes, so that’s a great question. So, here’s how insulin works. It’s kind of a two-part thing here. Okay, so Medicare Part B covers insulin if you use an insulin pump that’s covered under Part B’s durable medical equipment. Okay, okay, so it doesn’t cover insulin pens, and it doesn’t cover insulin related supply. But it’ll cover the pump under Part B, okay, that’s why I say it’s a two-part answer. So, part of, part of what you need, right? If you’re taking the pump, if you have a pump for it, yes, that’s covered under Part B, under the durable medical equipment.

 

Steve Sedahl  05:17

All right. So why is insulin not covered then?

 

Lisa Lauro  05:21

So, the insulin itself, like the quick pens, the injectable guys, like that. The insulin itself, if you get it, like, in a little bottle, like the human log comes in the little you know, right like, and you’re taking its sub-contan- subcutaneous, is that the right word? Something like that. But anyway, that is considered Part D. It’s a prescription that runs through your prescription drug coverage, and so that you go to the pharmacy and your Part D plan, your prescription drug plan, will cover your insulin that way.

 

Steve Sedahl  05:59

Okay, so it is covered, but it’s just a matter of understanding the various pieces of how you can put it together.

 

Lisa Lauro  06:05

Correct, correct. So that’s Yes, exactly. This could be a little bit of a puzzle. You have to kind of understand what you have, and then you’ll know where it’s getting built.

 

Steve Sedahl  06:15

I know a couple years ago, there was headlines constantly about the cost of insulin and how outrageous it was, and how people couldn’t get insulin, and so what has Medicare done to sort of tamp that down?

 

Lisa Lauro  06:28

Yeah, you know the great thing about it, because yes, you’re right, Steve, there were people that weren’t taking insulin, or they were only giving themselves a half a dose, which wasn’t helping, and could be life threatening because it was so expensive. So, thank goodness the government did do something about that. And in a couple of years back, I think it was 2023 when they started this, they capped insulin at $35 a month, and it’s going to follow through for 2026 and also, there’s no deductible that’s applied to insulin either. So that’s really important as well.

 

Steve Sedahl  07:04

Because before it was like in the 1000s, right?

 

Lisa Lauro  07:07

It could have been just depending, yeah, sure, sure, yeah.

 

Steve Sedahl  07:10

Well, so do you see any change coming in 2026?

 

Lisa Lauro  07:16

The only change with prescription drugs and not necessarily insulin, right? With insulin, I don’t really see a change. They’re going to keep the $35 cap. They’re not going to- you’re not going to have be subjected to a drug deductible on your insulin, and I think that will all remain the same. But for the prescription drugs, there is an increase in the cap from $2000 to $2100 so that is one of the changes for prescription drugs in general.

 

Steve Sedahl  07:47

All right, so we’re getting into fall, right? We’re rolling by Labor Day, and again, we’re looking- people are- should expect to see that if you’re on Medicare, that letter that comes every year about this time telling you what’s changing and what you need to do. How important is it to go through that?

 

Lisa Lauro  08:04

Oh, it’s so important that notice is called the annual Notice of Change, okay? And it’s a letter that you will get from your either your Medicare Advantage plan or your prescription drug plan. And it is so important for you to go through that now what I will tell you is the layout of the letter may vary according to how the insurance company lays it out, but what it’s going to do is it’s going to show you this is your current plan for this year, and this is what your plan is going to look like for next year. It’s not going to be a full summary, it’s just going to highlight what’s changing, okay, for the good or for the bad. So, it’s not everything is a negative change. Sometimes premiums go down, sure, sometimes costs go down, sometimes they go up. So, it, you know, but it will highlight. And so, you know, you have one, you have this annual enrollment period, that’s your time to make a change if you need to. So, if you just neglect looking at the letter, you don’t know if you need to make a change or not, right? And so that letter is so important for you to be aware of. And one thing you need to know, if you don’t get the letter in the mail, it’s possible that when you signed up for your plan, when you enrolled in the plan, you might have said you wanted all correspondence to come email to you, and if that’s the case, you’re not going to get a physical copy in the mail check your emails, because they are required to send you a letter, so not getting one isn’t an option. It’s either in your email or it’s at your door, in your mailbox. Okay, a lot of people forget that is important. But not only is it going to go over the changes of the plan, but for the drug piece of it, it’s very important as well. Don’t assume that your prescriptions are going to be taken care of, going to be paid for and have. The same copay next year as they are this year, because the prescription drug plans can also make a change, and they’re required to tell you what’s changing. If a medication is going from tier three to tier four, you’re going to pay for more. You’re going to pay more for it next year it’s a higher tier, so it’s going to cost you more if, if you have a plan that has, you know, a drug deductible this year. Let’s look and see what is the drug deductible next year, because this is your shot to make a change if you need to, and you don’t want that timeframe to go by. It’s from October 15 to December 7. Without doing your due diligence, your homework is to look at the paper, acknowledge the changes, and then make a decision on whether you want to make a change, or at least entertain the idea of another plan for 2026

 

Steve Sedahl  10:48

Lisa, let me ask you something and see if this is correct in your mind. So, let’s say I’m I have a particular drug, and they reduced the price on that to something pretty minimal. All right, let’s say it’s 50 bucks. It went from, let’s say it went from 300 to 50. Okay, yeah, now the pharmacy says that’s not enough money for me to make. I’m going to charge you extra. Do you hear that story?

 

Lisa Lauro  11:11

I don’t hear that story, huh? I don’t- that’s not a thing. Is it? I don’t think-

 

Steve Sedahl  11:17

It, well it is it for me, because they charged, because the pharmacy now charges me 100 bucks in addition to the 50 bucks that it costs.

 

 Lisa Lauro  11:25

No, yes, you need to look into that. Steve, I don’t think that’s a thing.

 

Steve Sedahl  11:29

That one puzzled me, but, but, and I called the pharmacy and he said, Well, yeah, that’s what we do.

 

Lisa Lauro  11:35

Well, perhaps you need to switch pharmacies.

 

Steve Sedahl  11:40

Perhaps I do. I don’t mean to go off on a (indistinct) of tangent.

 

Lisa Lauro  11:45

I mean, hey, maybe, well, your question might have, you know, hit, hit with somebody else as well. I mean, as far as I know, they’re supposed to just be whatever that, whatever the tier is, whatever the- whether it’s a coinsurance or a copay, coinsurance is in percentages. Co-pay’s a set amount. That’s what you should be paying. Did you? Did you take advantage of the plan, the payment plan, and maybe that’s why you’re paying a little okay?

 

Steve Sedahl  12:17

Anyway, we got to take a break. Lisa, we got lots more to talk about. We’ll dig into this a little bit deeper as Secure Money Health radio continues, and when we come back, we’re going to continue our conversation about Medicare and the annual enrollment period, what it is, what It isn’t, and so much more right after this. You Hey, we are back on Secure Money Health radio. That’s what we’re talking about. It’s where Medicare matters. Lisa Lauro’s here, and by the way, those the radio show is also available as a podcast. I would encourage you to check that out. I post it every Friday at noon for the show that airs that weekend. So again, and it’s a chance to really sort of put together a number of shows. And if you’re in the car for just a few minutes, pick it up where you left off with the podcast. And where do you go for that? You can go anywhere you get a podcast. One. You can go to your website, which is securemoneyhealth.com. Securemoneyhealth.com, or you can go to, you know, Apple, Spotify. Anywhere you get a podcast, you can find Lisa Lauro and Secure Money Health Radio.

 

Lisa Lauro  13:34

And what, and is that what it’s called, Secure Money Health Radio. Is that the name of the podcast? Okay.

 

Steve Sedahl  13:38

And again, you can search for it by your name, Lisa Lauro, or you can search for it by title, perfect, because it comes up both ways. I’ve done the search and again, don’t forget when you do that, just subscribe to it. We’ll send it to you every week. No problem. That’s awesome. I love that. Let’s go ahead and jump in here. We’re talking about Part B, and we’re talking about the changes- the letter- change- the change letter that comes this time of year. But, so, let’s talk about diabetes and self-management training. Is that a thing?

 

Lisa Lauro  14:11

It is, it is. And you know what that was? One of those things that, like, I didn’t know existed either, until I started really delving into, you know? Well, how does Medicare cover diabetes, right? And so earlier in the show, we talked about, you know, what’s covered and what isn’t covered. And we talked about insulin and then capping it. And now we’re going to talk a little bit about, how do we manage diabetes and what’s out there for the diabetic to utilize as a service. So, the first one is the acronym is DSMT, and it stands for diabetes self management training, okay? And this is an educational program designed to help individuals with diabetes learn how to manage. Manage their condition, right? That’s a that is a process, isn’t it? It is a process. And it’s not, you know, in most cases, I don’t think diet, it doesn’t go away, right? It’s just managing it. It’s my grandfather, and it’s just so, so managing the condition is the most important part of having diabetes, right? And so, there’s actually a program out there that many people aren’t aware of. So, it covers essential topics like blood sugar monitoring. And this is great for someone who’s a newly diabetic, just got diagnosed, healthy eating, physical activity that you need to do, medication adherence, coping strategies, because that’s a big pill to swallow when you learn that you have diabetes, right? Because it could be a big thing and it’s it changes your life, right? But the goal of the program here is to empower patients to take control of their health and then also to prevent complications, because if your diabetes is managed, you can minimize the complications you have for future, right? Okay, so very important.

 

Steve Sedahl  16:12

So, this sounds like- sounds like something that’s really important, and this is not especially if you’ve just been diagnosed. I mean, this goes back for me a few years where that, where they said they diagnosed me with type two, and so then it becomes this process of, how do I manage that? What do I have to do? And fortunately for me, it wasn’t, it wasn’t severe, but at the same time, yeah, it’s scary.

 

Lisa Lauro  16:35

It is. It is. And because it is like a life-changing thing, where you know, you have to now eat differently. You have to really think about things, right? You need to be- stay physical. You have to eat differently. Have to check your sugar. I mean, your whole day-to-day aspect changes. When you get diabetes, daily living changes.

 

Steve Sedahl  16:56

And the good news is there’s a lot of help out there. And we’re not talking from a medical standpoint, I’m thinking more from a support standpoint, like from you to help us understand, really, the backside of this, which is the complicated part. I mean, I can go to the doctor, they can take care of me, but oh my gosh, all the stuff on the on the backside, that’s where you come in.

 

Lisa Lauro  17:16

Right, right, exactly. And so, you know, you want to make sure that you’re on the right plan. You want to make sure that you’re doing all the right things, checking off all the boxes and again, yeah, that’s where I’d love to help guide you. And I know we’ve mentioned this before, but a meeting with me is complimentary. So come see me. I’m happy to help you through the process.

 

Steve Sedahl  17:34

We look at this. You mentioned nutrition. And again, eating is such a huge thing. Can I- is Medicare going to cover a nutritionist session for me?

 

Lisa Lauro  17:42

Yeah, yeah, they will. So, so this is how it’s covered. It says here, let’s see, because I was taking some notes on this. So, Medicare does include up to 10 hours of initial training, comprising one hour of individual instruction and nine hour of group sessions within a 12-month period, and the training you could be with a registered dietitian that’s a nutritionist. Obviously, often they play a key role in all of this, offering personalized guidance on meal planning and nutrition. So, it’s not just about planning the meals, but it’s eating healthy, right?

 

Steve Sedahl  18:25

It’s easier said than done, sometimes.

 

Lisa Lauro  18:27

It, oh, it absolutely is a lot easier said than done, because I think a big part of this is also portion control too, right?

 

Steve Sedahl  18:38

Well, sir, that for me, that was that has always been the trouble. And I mean, you know, in my case, yes, I was diagnosed type two. I started down this path and I couldn’t get away from it. They diag- or they prescribed Ozempic for me. That solved the problem. I lost 60 pounds. And, you know, that’s the story.

 

Lisa Lauro  18:56

That’s amazing, because it is. It’s truly so hard to lose weight the older we get. Yeah, you’re telling it’s an uphill battle, you know? And so, having clear help, yeah, it’s amazing.

 

Steve Sedahl  19:11

Anyway, folks, it’s a great opportunity for you to just learn about Medicare. And so how would we, how would we get started? In other words, if we’d just been diagnosed and we’re sort of on Medicare or getting there, can I just call you and just- “Lisa help me”?

 

Lisa Lauro  19:27

So, I’d be happy to help you with the Medicare aspect of it. But if you want information, yeah, but there’s also information with the this program, the diabetes self-management training program. So, I would direct someone to talk to their doctor about a referral, because you may need a referral for the program, but you can find accredited programs through the American Diabetes Association or the Association of Diabetes Care and Education Specialist. So that’s a starting point for folks, is go to the doctor. See if you can get a referral and then look up the American Diabetes Association to find a credited program in your area. This is all really good information for you, whether you’re just starting or you’re a long-time person who’s been diagnosed, it’s never too late to start planning your meals correctly, will learning about nutrition and trying to manage your diabetes better.

 

Steve Sedahl  20:28

Well, so, and here’s what I’ll do, I’ll go ahead and put a link to those, those two organizations that you mentioned. I’ll put those in the in the show notes of the podcast, so anybody that wants to just download the podcast, I’ll put the link there for you can go.

 

Lisa Lauro  20:41

Oh, that’s wonderful. Thank you. That’s a really nice thing to have, I think, for folks.

 

Steve Sedahl  20:46

Sure, all right. And again, one more reason to just go get the podcast right, right? Because we include good stuff we do and so, so that’s how we get started, right? I mean, that’s what we have to do as we again, say goodbye to summer. It was too short. But happen, I know so with the open enrollment that really is the only time if you’re already on Medicare, to really assess where you are if you want to change plans, if you want to make any changes, this is your opportunity.

 

Lisa Lauro  21:17

The annual enrollment period, October 15 to December 7 is your opportunity to make a change. If you’re on an advantage plan, and you pick a plan and then, for some reason, it’s just not sitting well with you. There is an open enrollment period from January to March that is specifically for folks on an advantage plan that want to switch to a different Advantage plan. So maybe there’s some aspect of it, or there’s, you know, you for some reason, maybe you didn’t have somebody check your doctors, and now you realize your doctor is not in the network, or your prescription, you didn’t check your prescriptions, you know, sure, but if something happens where you feel like you’re in the wrong plan or it’s not working out for you, you could use that that open enrollment in January, but it’s best just to take care of it. Come see us in October. We are so happy and willing and ready to help anybody that needs help with their Medicare. This annual enrollment period starting on October 15.

 

Steve Sedahl  22:17

Securemoneyhealth.com is your website, Lisa, give me the highlights that I mean, I know you’ve jam packed that with so much information.

 

Lisa Lauro  22:25

I know we did. Oh, my goodness. I think what’s really speaking to me is, you know, for the diabetics, I was astounded by how many people are diabetics in the country, and I myself, just started really focusing on meal planning. I am not diabetic, but my family, my mom is type two, my dad was type two, and two of my brothers are type two, and there’s six of us, and I’m thinking, you know, what the chances of me and I had, I had the what’s it called the pregnancy one, gestational diabetes, which puts me so my takeaway here today is, whether you’re diabetic now or not, start eating healthy. Really plan your meals, portion control. And if you are diabetic, go get a referral from your doctor to help go to one of these management programs to help you manage your diabetes Absolutely.

 

Steve Sedahl  23:24

And again, on that note, let’s we’ll just wrap it up for the for the show, Lisa, again, great information, and I know that we cover a lot of the same things, but again, it’s just so much information. It’s so important to know and understand, to just walk down this path.

 

Lisa Lauro  23:41

Yeah, I couldn’t agree with you more. I think this is, I really hope and pray that we are helping a lot of folks and educating them on lots of many different things throughout, from the you know, week to week.

 

Steve Sedahl  23:54

So sure. So again, give us a call. 724-242-6828, 724-242-6828, you go to securemoneyadvisors.com you can find Lisa there. You can actually fill out a form right there on the website, and that’ll connect with you as well. Any way you’d make it, any way you do it, though, folks, I would suggest that you just reach out and connect with Lisa as we get into Medicare season, so to speak, Lisa, Always a pleasure. Let’s come back next week and do it again.

 

Lisa Lauro  24:20

Let’s do it. Have a great week.

 

Speaker 3  24:24

Investment Advisory services are offered through Foundations Investment Advisors, LLC an SEC registered investment advisor. The content provided is intended for informational and educational purposes only. The views, statements and opinions expressed herein are those of the individual speakers and are not necessarily those of foundations and its affiliates. The information contained herein does not constitute an offer to sell any securities or represent an express or implied opinion or endorsement of any specific investment opportunity offering or issuer, any discussion of performance or returns is not indicative of future results. Any discussions of specific strategies are for informational purposes only, and have been provided to help determine whether they may be appropriate for your specific situation. If applicable, the primary goal in converting retirement assets into a Roth IRA is to reduce the future tax. Liability on the distributions you take in retirement or on the distributions of your beneficiaries. Each individual investor situation is different, and any ideas provided may not be appropriate for your particular circumstances. Comments regarding a particular client’s experience may or may not be the same as another client’s experience, and is not an indication that any client or prospective client will experience the same or a higher level of future success or performance. Foundations only transacts business in states where it is properly registered or is excluded or exempted from registration requirements. Registration as an investment advisor is not an endorsement of the firm by securities regulators and does not mean the advisor has achieved a specific level of skill or ability. Nothing herein constitutes a recommendation that any security portfolio of securities or investment strategy is suitable for any specific person. No legal or tax advice is provided. Please review your retirement tax and legacy planning strategies with a legal or tax professional before transacting or implementing any strategy discussed here and any comments regarding safe and secure investments and guaranteed income streams refer only to fixed insurance products. They do not refer in any way to investment advisory products. Rates and guarantees provided by insurance products and annuities are subject to the financial strength of the issuing company, not guaranteed by any bank or the FDIC. This is not endorsed or affiliated with the Social Security Administration, any federal Medicare program, nor any US government agency, if applicable, we do not offer every plan in your area, and contacting us at the phone numbers provided herein will direct you to a licensed insurance agent. Any information we provide is limited to those plans we do offer in your area, please contact medicare.gov or one 800 Medicare to get information on all of your options, all rights reserved.

 

Outro  26:57

Coach P Radio.